Temgesic/Buprenorphine

[Joolsg]

Jelbea and Shumbah have both posted recently about Temgesic versus Buprenorphine and the different half life of these 2 medicines.Both have Buprenorphine hydrochloride as the active ingredient BUT Temgesic has a much shorter half life.

This means it will have to be taken every 6 to 8 hours throughout the day to avoid mini opioid withdrawals. The main symptom of opioid withdrawals is SEVERE RLS.

Buprenorphine has a half life of 24 hours so only needs to be taken at night and will cover daytime RLS and not cause opioid withdrawals.

Yet again, the lack of knowledge amongst doctors about RLS and the pharmakinetic properties of drugs is causing unnecessary suffering.

Temgesic is NOT licensed in the UK for RLS, nor is Buprenorphine so there should be no reason for doctors to prescribe Temgesic over Buprenorphine.

I attach relevant articles which might help you persuade your doctors to prescribe plain Buprenorphine over Temgesic.

Temgesic does NOT appear to be available in the USA. I've asked Dr Berkowski about it and he only knows of Buprenorphine buccal, pills or patch.

On behalf of those struggling on Temgesic, I feel your rage and frustration.

Aaaaaaaaaaagh!!!!!

go.drugbank.com/drugs/DB0092

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medicines.org.uk/emc/produc...

Amendment

I've done a LOT of further research on this subject. Many articles mention Temgesic has a shorter half life. HOW, I've looked at all the medication leaflets online and the pharmakinetic properties as listed in research papers.

Temgesic has EXACTLY the same pharmakinetic properties as Buprenorphine. It comes in 0.2mg pills, so the only difference might be that the lower dose is not as effective as Buprenorphine, which starts at 0.4mg pills.

I can find nothing to show Temgesic is any different to Buprenorphine.

Different brands may produce different results.

[Lola43]

thank Joolsg, I think I am going to request buprenorphine at my next review with prof Walker in October as I’m currently on oxycodone twice a day and I’m still having rls in the afternoon and early hours of the morning so at my request he has increased the dose by 10mg at lunch. But I don’t think it lasts too long. It’s supposed to last 12 hours but I don’t think it does at all

[Joolsg in reply to Lola43]

Oxycontin DEFINITELY doesn't last 12 hours. Have a look at the Netflix documentary on the OXYCONTIN scandal in the USA. The Sackler family claimed Oxycontin lasted 12 hours. That was proven to be a lie.It lasts about 4 hours. Then you have mini withdrawals throughout the day, causing RLS.

There are a few people on here who do very well on Oxycontin twice or 3 times a day and some who do well on the shorter acting oxycodone, taken only at night.

However, there are too many people who find it just doesn't cover RLS and they get breakthrough in the day and at night. Then they increase the dose and the same thing happens.

I wasted 5 years on 25mg Oxycontin and 150mg pregabalin and my RLS was still in.the severe, every day, every night category. Professor Chaudhuri at King's College said there was nothing more he could do. I wrote to Dr Buchfuhrer and he was appalled. I then pushed and pushed him for Buprenorphine and he eventually sent me an email saying he had no objections IF my GP would agree. Luckily for me, she agreed and it's not red listed here in London.

It's why they prescribe methadone and Buprenorphine in the USA for refractory RLS. The half life of both is much longer so a lower dose covers symptoms for 24 hours.

It's why UK doctors and neurologists need to learn and study RLS and the pharmakinetic properties of drugs.

Check first if Buprenorphine is on the red list in your area. If so, you need Prof Walker to prescribe it AND ensure future prescriptions are issued. Your GP won't be able to prescribe it.

I'll hopefully be setting up a fund raising page soon to raise money for trials of Buprenorphine ( not temgesic!). It's the only way we can get it licensed for RLS here in the UK.

[Jelbea in reply to Joolsg]

Hi Joolsg - Sorry for the delay in responding to your post. Dealing with other medical issues.

As regards the Temgesic I have now been able to get changed to Tephine which is the Sandoz version of buprenorphine hydrochloride. I could not get Accord which you have said you find best.

Anyone finding difficulty with Temgesic if they could ask for their prescription to say "buprenorphine hydrochloride". In some areas there is a shortage of Temgesic so I used this to get my prescription changed. Also tell the GP that Temgesic is much more expensive. Then my pharmacist was too lazy to try round to get anything other than Temgesic so I changed pharmacists. The lovely man I now have is most helpful and got Tephine. He is also going to try for Accord but here in NI we are much more limited in what we can obtain (thanks to EU and Brexit mess) and having to pay much higher prices than the rest of UK. (Rant over).

As regards what I am finding since changing, I do think I am having better results with the Tephine. Unfortunately because I have been taking three doses spaced over the day my system has become used to this but I am still experimenting on timing and hoping I might eventually be able to take it only in the evening. However, in saying this I am experiencing 90+% coverage and am well able to accept this. Although bup still causes some depression it is not nearly as bad as oxycodone for me and I have to remember that RLS is not the only ailment I am suffering and having to take heavy drugs to keep me going so a bit of depression is not surprising.

All the best in your endeavours and let us know how we can help.

[LotteM in reply to Jelbea]

Hi Jelbea, that seems to be a change for the better! Keeping my 🤞🏼 crossed it lasts and eben improves.

[Jelbea in reply to LotteM]

Hi Lotte, Thanks you for your good wishes. Things are probably the best they have been for a long time. I see your patches are working well for you and hope this continues for a long time.

[Joolsg in reply to Jelbea]

I'm so pleased to hear that. I will be able to start a fundraising GoFundMe soon. I just have a few more phone calls with Doctors who may be able to do the trials.We will then need to publicise it far and wide and get as many people involved on here, Facebook Groups and elsewhere.

Hope you sleep well.

[Jelbea]

Thanks Joolsg. Looking forward to hearing what we need to do to help.